Online Appointment Form

The Easiest Way to Request an Appointment

* Please note that filling out this form does not constitute a confirmed appointment.
* Our reception desk will get in touch with you to confirm your appointment date and time.

Your Name (required)

Your Email (required)

Your Phone Number (required)

Symptoms / Reasons for Appointment

Requested Date & Time you would like for your appointment

Contact

  • Braceline Center for Orthodontics and Oral Implants
    183 Kasangula Road, entrance Nanzila Road, Roma
    Lusaka, Zambia
  • Phone: +26 097 30 65 556
    +26 095 06 55 556
    +26 0211 29 00 40
  • Email: info@bracelineorthodontics.com

Social Media

START TYPING AND PRESS ENTER TO SEARCH